Provider Demographics
NPI:1528790037
Name:HALL, KATHLEEN L (LMFT)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:L
Last Name:HALL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5350 SANDRA WAY
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-3223
Mailing Address - Country:US
Mailing Address - Phone:303-915-6004
Mailing Address - Fax:
Practice Address - Street 1:4251 KIPLING ST UNIT 560
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6800
Practice Address - Country:US
Practice Address - Phone:720-316-7908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-24
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFT.0002471106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist